A 5150 hold in California is an involuntary psychiatric detention of up to 72 hours that a peace officer, a designated county clinician, or certain other authorized professionals can initiate when a mental health crisis makes a person a danger to themselves, a danger to others, or gravely disabled. The authority comes from the Lanterman-Petris-Short Act, and the 72-hour clock starts the moment the person is first detained, not when they arrive at a psychiatric facility.1California Legislative Information. California Code WIC 5150 The hold itself is only the beginning; the rules that govern how it plays out, and what follows it, are where most people get caught off guard.
Who Can Initiate a Hold and On What Grounds
California limits this authority to a defined list: peace officers, the professional in charge of a county-designated evaluation and treatment facility, members of that facility’s attending staff, members of a mobile crisis team, and other professionals individually designated by the county.2California Legislative Information. California Code WIC 5150 A family member, neighbor, or coworker cannot place a hold. They can call 911 or a county crisis line and request an evaluation by someone who has that authority.
The person initiating the hold must have probable cause to believe the individual meets one of three criteria as a result of a mental health disorder: danger to others, danger to self, or gravely disabled.1California Legislative Information. California Code WIC 5150 A diagnosis alone is not enough. There has to be a current, observable risk.
“Gravely disabled” is the criterion most people underestimate. Under California law it means a person who, because of a mental health disorder, cannot provide for their own food, clothing, or shelter.3California Legislative Information. California Code WIC 5008 Someone wandering in traffic without awareness of surroundings, or in severe self-neglect driven by psychosis, can meet this standard without ever having threatened anyone.
What Happens in the First 72 Hours
The professional initiating the hold completes a written application setting out the factual basis for the detention. That application becomes part of the record and is what the receiving facility reviews on admission.2California Legislative Information. California Code WIC 5150 Vague paperwork here is one of the more common grounds for challenging a hold later.
Law enforcement or emergency medical personnel transport the person to a county-designated psychiatric facility. Not every hospital qualifies; the facility must be specifically approved by the county and the California Department of Health Care Services.1California Legislative Information. California Code WIC 5150 That sometimes means bypassing the nearest ER.
On arrival, a clinician conducts an initial assessment. If the person no longer meets the criteria, the facility can decline admission and release them. If admitted, evaluation continues with a psychiatric exam, a review of medical and mental health history, and information from family or caregivers where available. Assessment is required on an ongoing basis throughout the 72 hours, not just at intake.1California Legislative Information. California Code WIC 5150 If clinicians conclude at any point that the criteria are no longer met, they must release the person. Most people are released before the 72 hours run out.
How Long a Hold Can Actually Last
The initial 72 hours can be extended through a defined series of steps, each with additional procedural protections.
14-Day Certification
If a person continues to be a danger to self, a danger to others, or gravely disabled at the end of the 72 hours, the facility can certify them for up to 14 additional days of intensive treatment.4Riverside County Department of Mental Health. What to Expect on a 14-Day Hold This requires formal written notice and triggers the right to a certification review hearing.
Additional 14 Days for Suicidality
At the end of a 14-day certification, someone who threatened or attempted suicide during either the 72-hour evaluation or the 14-day hold, and who continues to present an imminent threat to their own life, can be confined for another 14 days of intensive treatment.5Justia Law. California Code WIC 5260-5268
180-Day Post-Certification Hold
The longest involuntary hold under the LPS Act is a 180-day post-certification period. It applies only when a person has attempted, inflicted, or made a serious threat of substantial physical harm to another while in custody for evaluation and treatment, and continues to present a demonstrated danger of substantial physical harm as a result of a mental health disorder. A court must approve it, and the person has the right to a jury trial.
LPS Conservatorship
When someone is gravely disabled and extended treatment has not resolved the condition, the county can petition for an LPS conservatorship. It is granted initially for one year and can be renewed annually, and the person has the right to a jury trial before it is imposed.6Superior Court of California, County of Orange. LPS Mental Health Conservatorship
Your Rights While Detained
Being held involuntarily does not strip your civil rights. Several protections apply from the moment the hold begins.
Notice
Facility staff must give you written notice of why you are being held, the legal basis, and a summary of your rights, in a language you understand.1California Legislative Information. California Code WIC 5150 If the hold is extended to a 14-day certification, you receive separate written notice and are informed of your right to judicial review through a writ of habeas corpus.7California Legislative Information. California Code WIC 5254.1
Attorneys, Advocates, and Contact With the Outside
You can contact an attorney at any point during the hold. If you cannot afford one, a public defender or patients’ rights advocate can be provided. California’s Office of Patients’ Rights, operated by Disability Rights California, serves people in psychiatric facilities and can investigate rights complaints.8Disability Rights California. California Office of Patients’ Rights (COPR) You also have the right to make phone calls and receive visitors, unless the treatment team documents a specific safety reason to restrict contact.
Refusing Medication
This part surprises people. Even on an involuntary hold, you generally have the right to refuse antipsychotic medication. The facility must disclose the proposed medication, its effects, and your right to refuse.9California Legislative Information. California Code WIC 5332 If you refuse, staff cannot override your decision on their own. They must request a capacity hearing, commonly called a Riese hearing, at which a hearing officer or judge decides whether you have the mental capacity to make treatment decisions. Only a finding that you lack capacity allows involuntary administration.10DHCS. Rights for Individuals in Mental Health Facilities
The narrow exception is a genuine psychiatric emergency where medication is needed to prevent immediate harm and alternatives like seclusion or restraint are unavailable or ineffective. Outside that window, a refusal stands until a capacity hearing says otherwise.
Medical Privacy
Federal and state privacy protections continue to apply during a hold. Treatment staff can access your records for care purposes, but outside parties generally cannot obtain them without your written consent, apart from exceptions for imminent safety threats and court orders. Casual inquiries from employers, landlords, or acquaintances get nothing.
Challenging the Hold
If you believe the hold is not justified, more than one route is open to you.
Certification Review Hearing
When a 14-day hold is initiated, a certification review hearing must be scheduled within four days. It is informal, typically held at the hospital, so you are not transported anywhere. A neutral hearing officer weighs the facility’s evidence, your response, and any testimony from a patients’ rights advocate. You can present evidence and call witnesses. If the hearing officer finds no probable cause to continue the hold, you must be released.4Riverside County Department of Mental Health. What to Expect on a 14-Day Hold
Writ of Habeas Corpus
At any point during a hold, including during the initial 72 hours, you or someone acting on your behalf can file a petition for a writ of habeas corpus in superior court.11California Legislative Information. California Code WIC 5275 This is a more formal proceeding. A judge examines the lawfulness of the detention, and you have the right to counsel, to cross-examine witnesses, and to present evidence. If the court finds the hold unjustified, it orders immediate release. On a 14-day certification, habeas is available whether or not you have already had a certification review hearing.
Filing a Complaint
Rights violations during the hold, such as forced medication without a capacity hearing or denial of phone access, can be reported through the California Office of Patients’ Rights.8Disability Rights California. California Office of Patients’ Rights (COPR) The Department of Health Care Services Mental Health Ombudsman is another point of contact for help navigating the system.12DHCS. Ombudsman Serious violations can also support a civil suit for improper detention.
Firearm Prohibition
A 5150 hold carries a consequence that outlasts the hospitalization by years. Under California law, a person detained for evaluation under Section 5150 is prohibited from owning, possessing, or purchasing firearms for five years from the date of detention.13Justia Law. California Code WIC 8100-8108 The prohibition attaches to the detention itself, whether or not you were ultimately found to meet the criteria.
California reports these holds to the National Instant Criminal Background Check System, so gun dealers anywhere in the country will see the prohibition on a background check.14HHS. HIPAA Privacy Rule and the National Instant Criminal Background Check System You can petition the court for early reinstatement, but the burden is on you to show you are no longer a danger, which typically requires expert evaluations and a hearing.
Costs and Insurance
An involuntary hold produces real medical bills. A three-day hold can easily run into the thousands, and ambulance transport adds more.
If you have private insurance, the federal Mental Health Parity and Addiction Equity Act requires your plan to cover psychiatric inpatient care on terms no more restrictive than coverage for medical or surgical hospitalization. For plan years beginning January 1, 2026, updated rules strengthen enforcement against plans that impose harder-to-meet requirements on mental health treatment.15U.S. Department of Labor. Fact Sheet – Final Rules Under the Mental Health Parity and Addiction Equity Act If you have Medi-Cal, inpatient psychiatric services are a covered benefit, and the county mental health plan typically handles authorization. Uninsured patients may qualify for county-funded emergency mental health services, with details varying by county.
Request an itemized bill after discharge and review it. Billing errors in psychiatric facilities are common, and you have the right to dispute charges. Many hospitals also run financial assistance or charity care programs.
Job Protection After a Hold
A hold does not automatically cost you your job, but it leaves an attendance gap that has to be managed.
The Family and Medical Leave Act allows eligible employees to take up to 12 workweeks of unpaid, job-protected leave for a serious health condition, and inpatient psychiatric care qualifies. To be eligible you must have worked for the employer at least 12 months, logged at least 1,250 hours in the past year, and work at a location with 50 or more employees within 75 miles. If you meet those requirements, your employer must restore you to the same or a virtually equivalent position on your return.16U.S. Department of Labor. Fact Sheet #28O – Mental Health Conditions and the FMLA
The Americans with Disabilities Act adds another layer. An employer cannot fire you simply because you have a psychiatric condition, and if you need adjustments on your return, such as a modified schedule or a gradual increase to full duties, the employer must engage in an interactive process to explore reasonable accommodations. The ADA does not require an employer to excuse poor performance, so the practical move is to request accommodations proactively rather than waiting for a performance issue to develop.
A useful tactic: have a family member or advocate notify your employer that you are on medical leave. You do not have to disclose that the hospitalization is psychiatric. A statement that you are hospitalized and expect to return by a certain date preserves your leave rights without sharing more than necessary.
Release and Follow-Up
When you no longer meet the criteria for involuntary detention, the facility must discharge you. Before release, staff should conduct a final assessment and provide a written discharge plan with follow-up treatment recommendations, crisis hotline numbers, and referrals to community mental health services. A standard 72-hour hold does not allow the facility to force outpatient care as a condition of release.
A separate path exists for individuals with repeated hospitalizations or specific clinical histories. California’s Assisted Outpatient Treatment program, known as Laura’s Law, allows courts to order community-based treatment when clear and convincing evidence shows a person is unlikely to survive safely without supervision, or that treatment is needed to prevent a relapse likely to result in grave disability or serious harm.17California Legislative Information. California Code WIC 5346 A court-ordered plan can include medication management, therapy, housing assistance, and regular check-ins.18DHCS. Assisted Outpatient Treatment Program
If you were held during a crisis and released without a clear plan, county mental health departments offer walk-in services and can connect you with ongoing care. The handoff from inpatient crisis care to stable community treatment is where the system most often breaks down, so having a family member or advocate help coordinate follow-up matters.